American journal of preventive medicine
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Similar to the well-documented racial inequities in health status, disease burden, healthcare access, and hospitalization, studies have generally found higher rates of hospitalization resulting from ambulatory care-sensitive conditions for blacks compared to whites. Beyond identifying disparity in rates of disease or risks of hospitalization, identifying disparity in age at hospitalization may provide deeper insight into the social and economic effects of disparities on individuals, families, and communities. ⋯ Racial disparities in age at preventable hospitalization exist across a spectrum of conditions. This difference in age at hospitalization places an undue burden on individuals, families, and society with long-term health and financial sequelae. Promoting equity in disease prevention, management, and treatment should be a priority of any healthcare reform efforts.
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Traumatic brain injury (TBI) is a life-altering condition that has affected many of our soldiers returning from war. In the current conflicts, the improvised explosive device (IED) has greatly increased the potential for soldiers to sustain a TBI. This study's objective was to establish benchmark admission rates for U.S. Army soldiers with TBIs identified during deployment to Iraq and Afghanistan. ⋯ Future surveillance of TBI hospitalization rates is needed to evaluate the effectiveness of implementation of preventive measures.
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Medical information systems during past military deployments had limited injury surveillance capability as data were not accessible during deployments and did not capture causes of injury. This paper describes nonbattle injury (NBI) results from an ongoing surveillance program that identifies injury occurrences and causes during deployments for Operations Iraqi Freedom (Iraq) and Enduring Freedom (Afghanistan). ⋯ Routinely collected air evacuation records provided the basis for ongoing injury surveillance for Iraq and Afghanistan. NBI was the largest category of evacuations from both operations. Leading NBI causes were similar to those identified for previous deployments and many should be preventable.
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Injuries are the leading cause of morbidity and mortality confronting U. S. military forces in peacetime or combat operations. Not only are injuries the biggest health problem of the military services, they are also a complex problem. ⋯ The purpose of this paper is to: (1) review the steps of the public health process for injury prevention; (2) review literature on evaluation of the scientific quality and consistency of information needed to make decisions about prevention policies, programs, and interventions; and (3) summarize criteria for setting objective injury prevention priorities. The review of these topics will serve as a foundation for making recommendations to enhance the effectiveness of injury prevention efforts in the military and similarly large communities. This paper also serves as an introduction to the other articles in this supplement to the American Journal of Preventive Medicine that illustrate the recommended systematic approach.
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Low-income and minority children have higher rates of obesity and overweight. Greater understanding of their food access is important. Because of higher rates of walking to school in these populations, these children likely have greater exposure to the food environment immediately around their schools. Mobile food vendors are an understudied aspect of the food environment in U.S. urban areas. ⋯ Mobile food vendors in urban areas contribute to after-school snacking among children, and should be considered as a component of the school food environment.